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House passes health care reform

ST. PAUL - Smokers and obese Minnesotans would be targeted for health-improvement programs, soaring health-care costs could slow a bit and thousands more Minnesotans would be added to public programs.

Those are among provisions in a controversial health-care reform bill state representatives approved 83-50 late Thursday after more than seven hours of debate. It and a more extensive bill senators earlier passed face a questionable future because Gov. Tim Pawlenty opposes part of the measure, although he says he wants reform, too.

Pawlenty would use money from the Health Care Access Fund in his budget-balancing plan. That is the fund Democratic-Farmer-Laborite lawmakers want to use to expand state health-care coverage and make other changes to the health system.

He said there will be two choices once the access fund runs out - raise taxes or take people off state programs.

The average Minnesotan would notice a couple of improvements if the bill becomes law, House Majority Leader Tony Sertich, DFL-Chisholm, said.

For one, health insurance premiums should fall, Sertich said, because expensive care provided people without insurance - but which often ends up on the state's tab - will be curtailed.

Also, the leader said, the bill sets a goal of keeping insurance premiums to no more than 6 percent of a person's salary. That is achieved, in part, with state subsidies.

Highlights of the bill, which would cost $225 million when fully ramped up in 2010-2011, include:

-- State-funded health programs would add thousands of Minnesotans to their rolls by 2011.

-- Ninety-six percent of Minnesotans would have health-care coverage by 2011, counting both private and public programs.

-- A mandate would simplify paperwork required of health-care providers such as doctors.

-- A provision would spend $100 million over three years to promote better nutrition, physical fitness and preventive measures on the assumption that such moves would reduce obesity, tobacco use, alcohol abuse and drug addiction.

The state's main insurance program for the poor, MinnesotaCare, would gain 28,000 enrollees under the bill. It would provide insurance to a family of four earning $61,500 annually once medical expenses top $3,690.

Republicans see a problem with how health-care providers would be paid under the bill. Rep. Matt Dean, R-Dellwood, said those providers don't understand how the provisions would affect them.

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Rural health-care providers, in particular, are not ready for major changes in how health-care data is reported, Dean said. "We don't know how this is going to work, but (Democrats say) we have to implement this immediately."

Rep. Laura Brod, R-New Prague, said the world-famous Mayo Clinic in Rochester cannot even figure out how to deal with the bill's changes, so small-town providers cannot be expected to understand.

However, Democrats produced letters from several medical groups, including Mayo, supporting the bill.

Representatives seemed to agree with at least one of the bill's goals: reduce chronic diseases. Rep. Tom Rukavina, DFL-Virginia, said that is an important issue, even though he admitted to being a smoker and being overweight.